Mental Disorder According To Bartlet

Published Date: 02 Nov 2017

PUT CONFINMENT IN INTRO! And about brief history of mental health law in uk

Discuss capacity/incapacity laws how they are all included in ni?????

Discuss four categorise of mental disorder according to Bartlet page 56

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Mental health law according to Bartlett (2003) is as old as law itself, with the earliest classified reference in the English law book as far back as 1324. This law gave the King authority over persons and property of ‘idiots’ and those who lost their ‘wit’. It was not until the late eighteenth and predominantly nineteenth century that the insane gradually became subject to legal authority. Although these statutes were the precursors of the Mental Health Act (MHA) (1983) they were significantly different systems. Much of the nineteenth century saw mental health law in a variety of streams of statutes and each one independent from the other as opposed to a single act. The nineteenth century also saw a structure of laws relating to the clarification, modernising and justifying that related to the Royal Prerogative powers. These powers allowed for control over a person and property once they were admitted to an asylum (Bartlett, 2003). Two significant developments in the first half of the nineteenth century saw another strand of legislation termed the Mental Deficiency Acts that began in (1913). This Thomson (1998) and Walmsley et al, (1999) believe provided a legislative framework for care in the community before the Second World War (Thompson (1998), Walmsley et al, 1999). The second development was the Mental Health Act, (1930) saw the beginning of informal admission, as up to this point there was no distinction between admission to and confinement to a psychiatric facility. It became possible for an individual to be admitted without a compulsory order of admission it also became possible for an individual to leave, this accounts for almost 90% of psychiatric admissions (Bartlett, 2003). The (1959) Mental Health Act moved control from hospital management to General Practioner (GPs) (Fennell, 1968). The (1959) Mental Health Act moved the power of the state to a legislative basis, it also places mental disorder and developmental disorder in the same law, and this continued until Mental Health Act (1983) in which confinement is an enforced treatment is performed on legislative justification and is measured by judicial assessment (Bartlett, 2003). The mental health act (1983) for England and Wales was based on UK ‘Better Services for mentally ill’ white paper (1975); and UK report of the Butler Committee on mentally abnormal offenders (1975), it covers four categories of mental illness:

 severe mental impairment,

 mental impairment,

 psychopathic disorder

 mental illness

Under the Mental Health Act (1983) an adult can be admitted, detained and treated in hospital against their wishes, this can be done under a number of different sections within the Mental Health Act (1983). Section 2 and 3 are used when someone’ needs to be assessed or treated and they are not a danger to themselves or the general public; this is termed a civil admission and can last for 28 days. An adult can be detained under section 4 of MHA if they are a danger to themselves or the public, this section allows a person to be admitted to hospital for an assessment of their mental health for a restricted period of time and requires the recommendation of only one doctor. This is dissimilar to section 2 which requires two medical recommendations. However, section 5 (2) and 5 (4) of MHA can be used by a doctor and a nurse respectively to prevent a voluntary patient leaving a psychiatric hospital (http://www.rethink.org). The (1983) act was amended by the Mental Health Act (2007), under this new act a host of professionals such as psychologists, mental health nurses and social workers are charged with overall care and treatment of patients. It also allows professionals who are not a registered medical practitioner to complete medical reports that are vital for detention renewal orders (Mental Health Alliance). A case example of this is Winterwerp v. Netherlands (1979) this case showed that detention application was accompanied by a medical declaration completed by a general practitioner, who had examined Mr Winterwerp for the first time. The court approved the temporary detention and did not pursue expert advice or consult with Mr Winterwerp. The European Court on Human Rights indicated that impartial medical expertise is vital in order to determine whether the patient has a mental disorder that justifies a detention. The EUHR went on to question whether or not this can be legally be achieved by non-medical professionals (Bartlett et al, 2007).

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The Mental Health Order (1986) for Northern Ireland was based on the mental health act (1983) more hereeeeeee ON COMPARISION BETWEEN MHO ENGLAND & WALES, SCOTLAND AND NI

The need for reforming the MHONI (1986) was recognised by the Bamford Review and the Northern Ireland Executive acknowledges the need for new for legislative reform by delivering the Bamford Vision to include changes to the existing Mental Health (Northern Ireland) Order (1986). This will also include new mental capacity statute and a report on human rights that would be followed by new mental health legislation for 2011 and mental health capacity by 2014. The NI executive also recognises that ideologies that were developed by the Bamford Review should be entrenched in the statute to cover mental health and capacity legislation. The main principle links to autonomy and the rights of the individual to make decisions and act on these decisions. The other central ideologies are:

 Justice, to apply the law equally and justly;

 Benefit, supporting the health, welfare and safety of the person, whilst having regard to the safety of others;

 Least harm, to ensure little harm to other people or persons.

These ideologies according to NI Executive will support an all-inclusive framework which will include all mental health provisions and capacity (dhsspsni, 2009).

As previously mentioned the nature of mental health law is multifaceted and contentious. Most prominent is the gravity that exists between preserving the patient’s autonomy and defending the patient and others from harm or risk. This together with autonomy is the concept of capacity where the decision making abilities of the individual need to be measured. In such cases, the person may not be able to make decisions themselves due to the nature of their condition. In Northern Ireland the Mental Health Order (1986) No statute dealing with capacity at present. In Scotland Mental Health Care and Treatment Act, (2003) has capacity-based mental health legislation based on 10 key principles.FROM PAGE 6 ON http://www.niassembly.gov.uk/researchandlibrary/2011/1811.pdf HEREE///////////

. DON’T FORGET TO USE RESOURCES FROM QOL /////////////////////

CAPICY/INCAPICY FROM HEREEEEE//////////////

Compare all three mental health acts eg mental health act 1983 applies to england and wales, Scotland has its own as does NI

Foucault believed confinement that began in the late eighteenth century under the supervision of the medical profession were both cruel and controlling. These institutions were the only place a person with mental health illness could get treatment (Foucault, 2006).

More on sociology and mental health hereeeeeeeeee////////////////////////////////////// KEEP BUT PUT SOMEWHERE ELCE

Admitting adults to hospital for psychiatric treatment without their consent remains a contentious subject and challenges the very foundation of modern day clinical practice—that of informed consent. However, if it is necessary to confine an individual a legal framework is required to protect them while they receive attention for their illness (REF). MORE ON CONFINEMENT

Human rights are also an important issues for an individual with mental health illness and these was not addressed until 19.. thereafter any acts were mindful of an individual’s human rights.

HEREEEEEEEE discuss legal framework and human rights, AND social policy stance ///////////////////////////////////////////////

USE REsOURCES ON QOL

. There is a balance to be achieved between, on the one hand, having the means to respond to the needs of, and/or risks posed by, a person considered to have a "mental disorder" who is not consenting to the proposed intervention, and, on the other, the risk that the use of such legislation poses with respect to a person's rights to autonomy.

HUMAN RIGHTS AND EU HEREEEEEE

CARE IN THE COMMUNITY

In July 2007, the government made amendments to the Mental Health Act 1983 and the Mental Capacity Act 2005. The government intended to modernise and improve the old legislation. A large part of the act remains the same; nevertheless, the new act presented very significant changes which include the introduction of the Supervised Community Treatment. This is the new supervision procedure for patients who are discharged from hospital and put back in the community. Another change is the redefining of the professional roles, which simply means that there are more mental health professionals treating and being responsible for one patient. Another change is the independent mental health advocacy. This gives mental health patients an opportunity to acquire a mental health advocate if they qualify.

The changes of the new mental health act seem to be very good and beneficial to mental health patients. It appears to be that the government really does care a lot about the nationâs well-being and mental health. However, by critically assessing these changes and looking behind the picture, we may find some weaknesses on how these services are being offered.